Evidence map›Paper›PMID 30135556›Full record

Trial reportNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2018

Do baseline sub-threshold hypomanic symptoms affect acute-phase antidepressant outcome in outpatients with major depressive disorder? Preliminary findings from the randomized CO-MED trial.

Manish K Jha, Ashley L Malchow, Bruce D Grannemann, A John Rush, Madhukar H Trivedi

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Manish K JhaCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, USA.
Ashley L MalchowCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, USA.
Bruce D GrannemannCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0000-0001-6888-7590
A John RushDuke-National University of Singapore, Singapore, Singapore.
Madhukar H TrivediCenter for Depression Research and Clinical Care, UT Southwestern Medical Center, Dallas, TX, USA. madhukar.trivedi@utsouthwestern.edu.ORCID http://orcid.org/0000-0002-2983-1110
Southwestern Medical Center · USThe University of Texas of the Permian Basin · US

Funding

TREATMENT RESISTANT DEPRESSIONN01MH90003 · NIMH · UT SOUTHWESTERN MEDICAL CENTER · 2007 to 2008
$9.1M
TREATMENT RESISTANT DEPRESSION-278990003N01MH090003 · NIMH · UNIVERSITY OF TEXAS SW MED CTR/DALLAS · 1999 to 2003
–
NIMH NIH HHS N01 MH090003NIMH NIH HHS N01MH90003
6 · The paper itself

Abstract

Sub-threshold hypomanic symptoms are common in major depressive disorder. This study evaluated the prevalence, the clinical and sociodemographic correlates, and the overall and differential effects of the presence/absence of sub-threshold hypomanic symptoms at baseline on acute-phase treatment outcomes with bupropion-plus-escitalopram combination, escitalopram monotherapy, and venlafaxine-plus-mirtazapine combination. Combining medications to enhance depression outcomes (CO-MED) trial participants (n = 665) were designated as sub-threshold hypomanic symptoms present (Altman Self-Rating Mania Scale score (ASRM) ≥ 1) or absent (ASRM = 0) and compared on clinical and sociodemographic features and remission rates. Participants with sub-threshold hypomanic symptoms (n = 335/665, 50.4%) were more likely to be black and non-Hispanic, have comorbid medical and psychiatric disorders, experience longer index episodes, and report lower depression severity and psychosocial impairment. Intent-to-treat remission rates were lower overall (absent = 42.7%, present = 34.0%, p = 0.02), with escitalopram monotherapy (absent = 45.8%, present = 31.6%, p = 0.03), and with venlafaxine-XR-plus-mirtazapine combination (absent = 44.4%, present = 30.1%, p = 0.03) but not with bupropion-plus-escitalopram combination (absent = 37.7%, present = 40.0%, p = 0.73). Participants without sub-threshold hypomanic symptoms were more likely to remit than those with such symptoms overall [odds ratio (OR) = 1.49], with escitalopram monotherapy (OR = 1.71), and with venlafaxine-plus-mirtazapine combination (OR = 1.97) but not with bupropion-plus-escitalopram combination (OR = 0.96), even after controlling for baseline depression severity, psychosocial impairment, and number of comorbid psychiatric disorders. Sub-threshold hypomanic symptoms (found in about 50% of patients in this report) were associated with lower remission rates with escitalopram monotherapy and with venlafaxine-plus-mirtazapine combination but not with the bupropion-plus-escitalopram combination.

Indexed as

AdultAmbulatory CareAntidepressive AgentsBipolar DisorderBupropionCitalopramDrug Therapy, CombinationFemaleHumansMajor Depressive DisorderMaleMiddle AgedOutpatientsSelf ReportTreatment OutcomeVenlafaxine HydrochlorideAntidepressive AgentsBupropionCitalopramVenlafaxine Hydrochloride

Identifiers

PMID30135556
PMCPMC6135801
OpenAlexW2886561749

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.